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General NPI Number Information
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NPI Number | 1548083629
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Entity Type | Organization
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Legal Business Name | BRANCH COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | PINES BEHAVIORAL HEALTH SERVICES 200 VISTA DR
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City | COLDWATER
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State | MI
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Zip | 49036-9998
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Country | US
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Telephone | 517-278-2129
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Fax | 517-279-8172
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Provider Business Mailing Address
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Address Line | PINES BEHAVIORAL HEALTH SERVICES 200 VISTA DR
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City | COLDWATER
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State | MI
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Zip | 49036-9998
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Country | US
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Telephone | 517-278-2129
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Fax | 517-279-8172
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Authorized Official
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Title or Position | CHILDRENS SERVICES DIRECTOR
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Name | MS. JENNIFER ROSE GIRON
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Credential | BCBA/LBA
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Telephone | 517-278-2129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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